Intra- and Intergenerational Consequences of Maternal Stress Exposure for Maternal-Infant Health in Black U.S. Families

美国黑人家庭母亲压力暴露对母婴健康的代内和代际影响

• 批准号: 10334854
• 负责人: Betty Lin
• 金额: $ 60万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT ALBANY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-06 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10334854
• 关键词: Acute; Adult; Age; Behavior; Belief; Biological; Birth; Black American; Black Populations; Black race; Cardiovascular Diseases; Cardiovascular system; Characteristics; Communities; Development; Discipline of obstetrics; Discrimination; Environmental Health; Environmental Risk Factor; Epidemiologist; Exclusion; Exposure to; Family; Fathers; Generations; Geographic Information Systems; Gestational Age; Glean; Goals; Gynecologist; Health; Health Promotion; Heterogeneity; Home visitation; Hydrocortisone; Infant; Infant Health; Interdisciplinary Study; Intervention; Knowledge; Life Cycle Stages; Link; Literature; Longitudinal prospective study; Low Birth Weight Infant; Maternal Exposure; Maternal Health; Maternal Mortality; Medical Records; Methodology; Methods; Modeling; Mothers; Nature; Neighborhoods; Outcome; Patient Self-Report; Pattern; Physiological; Physiology; Policies; Postpartum Period; Pregnancy; Premature Birth; Process; Psychologist; Psychophysiology; Race; Regulation; Research; Risk; Role; Salivary; Scientist; Shapes; Sinus Arrhythmia; Stress; Structural Racism; Suggestion; Testing; Time; Transact; United States; Woman; acute stress; behavior observation; black women; comparison group; developmental plasticity; early life stress; experience; fetal; indexing; intergenerational; maternal stress; novel; obstetrical complication; postnatal; prenatal; prenatal stress; programs; psychobiologic; psychosocial; psychosocial stressors; racial determinant; racial disparity; racial identity; racism; resilience; respiratory; social; sociodemographics; stressor

PROJECT SUMMARY In the US, Black mothers and infants experience disproportionately worse pregnancy-related health outcomes. Black mothers are 1.5-4 times more likely to die within a year of birth compared to non-Black mothers, and Black infants are 2-3 times more likely to die compared to non-Black infants. These elevated rates have further been tied to elevated rates of obstetric cardiovascular complications for mothers, and preterm birth and low birthweight for infants. The causes for these disparities are unknown, but evidence to date suggests that they are likely social and environmental in nature. Thus, there is an urgent need to identify the determinants of these racial disparities to elucidate the highest priority targets for intervention. The proposed research will evaluate how micro- (e.g., interpersonal, family) and macro-level (e.g., neighborhood, environmental) risk and resiliency factors transact to shape maternal-infant health. Additionally, this research interrogates the psychobiological mechanisms that underlie their associations (i.e., physiological stress dysregulation, as indexed by i.e., salivary cortisol, respiratory sinus arrhythmia, electrodermal activity). Specific aims are to: (1) determine the intra- and intergenerational health consequences of maternal exposure to multi-level stressors and resiliency factors both during pregnancy and across her life course, (2) evaluate the mechanistic role of maternal and infant stress physiology in shaping maternal-infant health, and (3) estimate the extent to which paternal support may promote maternal-infant health both during pregnancy and the postpartum. To achieve these aims, this prospective longitudinal study will follow 350 Black families (mothers, fathers, infants) from pregnancy through the first postpartum year, with home visits during pregnancy, and at infant ages 6 and 12 months. This research utilizes a multi-method approach, and draws from self-report, psychophysiological assessment, behavioral observations, medical record abstraction, and spatial analyses using Geographic Information Systems (GIS). Additionally, this research emphasizes risk (e.g., interpersonal and structural racism) and resiliency (e.g., racial identity, cultural beliefs and values) factors of particular relevance for Black Americans. The long-term objective of this research is to identify targets through which to promote health in generations of Black U.S. families.

项目摘要 在美国，黑人母亲和婴儿经历与怀孕有关 健康结果。黑人母亲在出生后一年死亡的可能性高1.5-4倍 与非黑色母亲相比，黑人婴儿死亡的可能性是 非黑色婴儿。这些升高的速率进一步与产科率提高有关 母亲的心血管并发症，早产和婴儿的低出生体重。这 这些差异的原因尚不清楚，但迄今为止的证据表明它们可能是 本质上的社会和环境。因此，迫切需要确定 这些种族差异阐明了干预的最高优先级目标。提议 研究将评估微观 - （例如，人际关系，家庭）和宏观级别（例如， 邻里，环境）风险和弹性因素交易以塑造产妇 健康。此外，这项研究询问了基于的心理生物学机制 它们的关联（即生理胁迫失调，如唾液皮质醇所索引， 呼吸窦性心律失常，电肌活动）。具体目的是：（1）确定 孕产妇暴露于多层压力源的内在和跨国健康后果 以及怀孕期间和整个生活过程中的弹性因素，（2）评估 孕产妇和婴儿胁迫生理学在塑造产妇健康中的机械作用， （3）估计父亲支持可以促进母性健康的程度 怀孕期间和产后。为了实现这些目标，这个前瞻性纵向 从怀孕到第一次，研究将跟随350个黑人家庭（母亲，父亲，婴儿） 产后年份，怀孕期间有家庭访问，在6岁和12个月的婴儿中。这 研究采用了多方法方法，并从自我报告，心理生理学中获取 评估，行为观察，医疗记录抽象和空间分析使用 地理信息系统（GIS）。此外，这项研究强调了风险（例如 人际关系和结构性种族主义）和弹性（例如种族认同，文化信仰和 价值）与黑人美国人特别相关的因素。这个长期目标 研究是为了确定促进美国黑人美国人的健康的目标 家庭。